Evidence and Consensus-based Imaging Guidelines in Birdshot Chorioretinopathy: Multimodal Imaging in Uveitis (MUV)...

Area of Science:

• Ophthalmology
• Medical Imaging
• Rheumatology

Background:

• Birdshot chorioretinopathy (BSCR) is a rare, bilateral inflammatory eye disease.
• Accurate diagnosis and monitoring are essential for managing BSCR and preventing vision loss.
• Standardized imaging guidelines are needed to improve consistency in BSCR assessment.

Purpose of the Study:

• To develop consensus-based imaging guidelines for diagnosing and monitoring birdshot chorioretinopathy (BSCR).
• To define the roles of various imaging modalities in BSCR management.
• To enhance the Standardization of Uveitis Nomenclature (SUN) criteria for BSCR.

Main Methods:

• A consensus-based approach using literature review and a nominal group technique (NGT) with uveitis specialists.
• Review of 15 representative BSCR cases with diverse imaging data (CFP, FFA, ICGA, OCT, FAF, OCTA).
• Development and voting on recommendations for imaging in BSCR diagnosis, activity assessment, and complication detection.

Main Results:

• Color fundus photography (CFP), fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) are key for BSCR diagnosis.
• ICGA is vital for detecting choroidal lesions; FFA is crucial for monitoring vascular leakage and treatment response.
• Optical coherence tomography (OCT) aids in detecting complications like cystoid macular edema; consensus was not reached on FAF or OCTA's role.

Conclusions:

• Consensus guidelines reaffirm the critical role of ICGA in BSCR management.
• The guidelines provide standardized recommendations for multimodal imaging in BSCR diagnosis and monitoring.
• These guidelines aim to improve the assessment of disease activity and complications in BSCR.